The literature demonstrates that few cancer studies have assessed psychosocial areas and even fewer have evaluated psychosocial intervention. Those that have intervened have generally been with more clearly rehabilitative patients. Yet, large numbers of cancer patients live a significant time with the knowledge that they are dying. Many of these are in nursing homes. There is a growing knowledge about the process of death and dying, with principles outlined for working with patients and families. To our knowledge, these principles have not been tested with an experimental design. The proposed research has 3 objectives: (a) to determine if late stage cancer patients discharged from hospitals to nursing homes differ from those who return to their own homes; (b) to assess outcomes of patients who go to either setting; and (c) to evaluate effectiveness of social intervention in the process of dying with a randomly assigned group from both settings. About 10 patients a month over age 40 with late stage cancer (life expectancy of more than 1 month but less than 12) will be entered over a 2 year period. Baseline ratings taken in the hospital include physical function, life expectancy, psychosocial function (depression, life satisfaction, alienation, self-concept, and locus of control). Families will be assessed on family functioning and economic dimensions. Patients and families will be followed as long as the patient lives at 3, 6, 9 and 12 months. Dependent variables will be a survival quotient (expected minus actual survival) along with changes in family functioning and psychological areas between those nursing homes and their own homes and between those randomly receiving intervention or no intervention. Social intervention is aimed at developing open communication between the patient and family, offering support, and enhancing self-esteem. Cost benefit data will be developed to assess the actual and social cost of caring for the patients in either setting. The results are expected to contribute new knowledge about the efficiency of intervention with dying patients, the association between psychosocial factors and length of survival, and the nursing home as a resource for late stage cancer patients.